Friday, December 28, 2007

Re-doing the Aspie Quiz

I decided to redo the Aspie Quiz because I wanted to get a copy of the nice diagram that goes with it. My results were as follows;

Your Aspie score: 168 of 200
Your neurotypical (non-autistic) score: 33 of 200
You are very likely an Aspie

A tiny bit higher than last time (161), probably changes depending on mood.

Anyway, this is the picture I was after.

Aspies and Pain Tolerance

Much has been said about aspies & feelings and aspies being able to tolerate higher amounts of pain. I don't think I've gone into either topic in any real depth yet.

In short, Aspies aren't supermen and superwomen... They can be hurt and often are in pain, whether it shows on their faces or not. They just complain about it less than some people I guess.

Emotional Pain
While it's true that sometimes an aspie will lack empathy and won't feel anything for a given situation. I'll discuss that in a later post (sorry). It isn't true to say that the feelings of aspies can't be hurt. They can. Sometimes the aspie will show a reaction to their hurt feelings and sometimes they'll lash out. More often though, aspies will simply remain silent and impassive despite internal turmoil.

Physical Pain
Wouldn't it be wonderful to be in a world without physical pain? Everyone feels pain to some degree - including aspies. It doesn't have to be a huge pain to be felt, a paper cut or scraped knees will always bring tears out in an aspie child.

So where does the "no-pain" idea fit in?

Aspies are very good at ignoring pain, particularly if they're engaged in their special interest. The sorts of pain most commonly "ignored" by aspies are things such as muscular/nervous pain, rather than wounds. Although wounds can also be ignored.

Why is this a problem?
Pain is our body's way of telling us to stop what we're doing and have a rest or seek medical assistance.

You can imagine the long term effects of ignoring a toothache or a muscular/nerve problem like RSI.

In fact, I can speak firsthand about the RSI problem, since I have it. It's strange, when I go to physio for my injured hands, it hurts when they work on them. I take my mind off the hurt but then they ask me whether I can feel "this" (as they squeeze a nerve or something) all the way down my arm to my hand. I can't tell them and it takes a little while to become "switched on" to the pain again.

It's not that the pain is gone, just dulled.

Thursday, December 20, 2007

Why is Aspergers associated with Autism?

I was always going to do this post but until two days ago when my youngest son was diagnosed with high functioning autism, the words were going to be different and this was going to be a rant.

Since then, I've spent a while trying to figure out his condition. Now I can see the link.

The Usual Reaction
I've always considered Aspergers to be quite different from Autism - I was certainly different to most of the autistic people I'd met, many of whom couldn't function in society because of the nature of their condition.

I think that my reaction is pretty much the same as most of the population. Like other "popular" conditions, such as schizophrenia, autism has been spoilt by a mis-representation in the movies. Movies only show the very worst and most sensational cases and even then, they make a lot up.

Sure, I knew that at least some forms autism actually resulted in "smarter" people who had no social skills. That happened in Mercury Rising with Bruce Willis right? It might also have been in "a beautiful mind" but I never got to see the film so I can't be sure.

If you are after a complete and accurate description of autism, you should refer to the Wikipedia article since I intend to only cover a small area;

Some Brief Facts
Autism is a mental condition which you are born with. Despite spammer/scam artist claims to the contrary, it can never be cured although in time, the "sufferers" may learn to hide some of the worst symptoms.

There is a split in autism that, separates "High Functioning Autism" from Low Functioning Autism. The main characteristics that set high functioning autism apart are an IQ of 80 or above and the ability to speak, read, and write. People with mild HFA have minimal problems getting (and keeping) employment and many are employed in highly technical environments.

Autism is grouped with four other pervasive developmental disorders (PDD), all of which have problems of social interactions and communication, restricted interests and repetitive behavior. Of the other four, Asperger's is closest to Autism in symptoms (and probably cause). Unlike Autism, Asperger's has no substantial delay in language development.

So What does it all Mean?
Basically, this means that there could be NO other differences between a child with Aspergers and a Child with High Functioning Autism other than a language delay. The cut off point for the language delay is 4 years of age. If the child is not capable of carrying out an "independent" conversation by the age of four, then they will be considered autistic. Note that the emphasis is on conversation, not on knowing the words, being able to read or being able to write. In my Son's case, you can ask him about preschool and he'll tell you a whole heap of facts and one-liners about what happened. It's generally a one way conversation.

This sounds a bit pedantic, and I guess the diagnosis is, but that's currently how it's done.

So, will this improve? It is difficult to say however in HFA, it is very likely that conversational skills will improve with practice, age and use. Eye contact could always be a problem, but there are other ways around that. The ability to hold conversations however will not necessarily "upgrade" a diagnosis to Aspergers, though I'm a little skeptical myself about that one.

The Spectrum
It is important to realize that there is a whole spectrum for autism, not just a few labels and that this means that there is almost infinite variation. The diagram below is very simple and does not cover much at all but it may give you some idea. In reality, the diagnosis would look much more like a star with various branches indicating IQ, communication ability, empathy, motor control etc. Each type of autism would have various characteristics and would define a certain shape on the star. The lines between one shape and another would be very blurred.

<--- Normal ------ Aspergers ----- HFA -------------------- LFA ---->

One Last Point
Whenever anyone is told about an autism diagnosis, their first reaction is usually something along the lines of " that can't be it because he shows empathy or has emotions". I'm going to quote from Wikipedia since I can't think of a better way to end this point.

They do not lack empathy (although they may have difficulty expressing it), and can thus enjoy films and stories with emotional content. Some may gain the bulk of their insight into why people behave the way they do through watching movies that provide a forceful and musically-cued "capsule lesson" in human emotions (e.g. melodramas).

Sunday, December 16, 2007

How the whole Asperger's thing can be Detrimental to your Health

There are a few things about the Asperger's condition which can seriously affect the health of the individuals concerned.

This obviously won't be an exhaustive list, but it's a few things to consider.

Undereating in Children
While it is true to say that no child has ever starved itself willingly with food in easy reach, it is probably also true to say that no Aspie child has eaten healthy food when there are unhealthy alternatives available.

Aspies have a lot of problems with the texture of food as well as the taste. For some reason, the junk food manufacturers seem to have figured out a way of giving their foods fairly good textures since junk foods, such as lollies and ice cream rarely pose a problem to the aspie.

Aspie adults can take responsibility for their own healthy eating habits however aspie children need to be carefully monitored.

The other eating problem that aspie children have is that they seem to be much slower at eating than other children. This is probably a result of their susceptibility to distraction. As a result, aspie children often do not manage to eat their school lunches in time. I am not really sure what you can do to overcome this problem however I remember from my school days that I didn't eat lunch but often had six slices of bread immediately on walking in the door at home. It never seemed to prevent me from eating my dinner.

One last point about eating... Remember that the side-effects of medications such as Ritalin can sometimes worsen the eating problems by suppressing appetite.

Problems of Perfection
While perfection-related problems do affect aspie children (particularly in the later school years), they are far worse in aspie adults.

The problem is that Aspies tend to work on things until they reach a level of perfection that they are comfortable with. This means that they are often working harder and longer hours than their colleagues.

Obviously this can lead to workplace injuries and in particular overuse injury. I have first-hand experience of this because I work in the computing field and do so much keyboarding and mousing that sometimes my arms ache for weeks. Since so many aspies work with computers, it's a common problem.

Ignoring Pain
I plan to do a full post on how aspies can ignore pain so I wont go into a great deal of detail here. What I will say is that ignoring (or being able to ignore) the human body's signals of pain can result in longer term injuries. Sometimes, we aren't even aware that we are blocking pain out. This can be quite dangerous.

Tuesday, December 11, 2007

Asperger's and Ritalin

This post is bound to be a little controversial - sorry.

Technically, there is no medication that helps aspergers in general however Ritalin can relieve some of the symptoms. In this post, I'll attempt to explain what Ritalin does, which symptoms it addresses and how it affects youinger children.

Our experience
We have a seven-year-old son on Ritalin. Sometimes, we forget to give it to him. When this happens, we almost always get a phone call or a note from the school asking if we have forgotten to give him the medication. I think they have only ever asked once when we have actually given him the medication. It is therefore obvious that Ritalin provides a positive benefit in his behaviour and ability to work in class.

Interestingly enough, these comments come from teachers who were initially very resistant to the introduction of Ritalin. Such a turnaround implies obvious benefit.

The Ritalin does not suppress all of the aspie traits but instead allows him to think before acting. This reduces his impulsive behaviour while also preventing him from being distracted by everything around him.
It allows for better concentration and reduces his tendency to irritate his friends. We have asked our son how he feels on the medication and he has told us that he feels better. At age 7, there is not really a lot of information he can give us but we'll continue asking in case the situation changes.

We haven't seen any of the reported side-effects.

Is it safe? and What about the Side-Effects?
This is the question everyone wants answered before they give drugs to their child. In our case, we deliberated for about 6 months before starting and spent quite a while looking up the side-effects etc. We also looked at dietary changes and tried some natural remedies, like fish oil.

Ritalin has been in use since the 1960's as a treatment for ADHD. There have been lots of studies of its use. The most commonly reported side effects lack of sleep and lack of appetite. There have also been reports of stomach ache. Strangely enough, our son already had a reduced need for sleep and lack of hunger. I've had the same thing for most of my life (I once had a nickname of "sparrow" because of my eating habits). I've "normalised" in the last few years.

I think that the eating and sleeping may be aspie traits, which means that the Ritalin research could be flawed.

So far, research does not seem to have found anything too disturbing about Ritalin. There is evidence that it has minor effects on growth (in the early years but apparently kids catch up in the teen years). There is also evidence to suggest that it positively supports brain development.

There were also a lot of claims made that Ritalin, because of a similarity to cocaine, could lead to drug abuse. These claims have since been discredited. You can read a lot more about Ritalin on wikipedia.

Some people also report sweaty palms and a racing heart. There's a whole list of possible side-effects. I guess the best advice is: "If you notice any side-effects in your child - stop them taking the medication and see your pediatrician".

The other side-effect to look out for is "dopeyness". This indicates that the child is on too high a dose. The medication needs to be reduced.

Why does the need for medication increase?
This was a question I asked myself about a year ago. It turns out that the required dosage of ritalin depends on body weight. As the child grows, so does the required dosage.

Which symptoms does Ritalin Affect?
Ritalin is a stimulant which has a "calming effect reducing impulsive behavior, and facilitates concentration on work and other tasks".

Ritalin and Statistics
There are a lot of statistics around about Ritalin and all sorts of side effects. In pretty much every case I have seen, the studies don't have appropriate control groups. This means that the data in their statistics is meaningless. This lets us right into the Anti-Ritalin groups.

Anti Ritalin groups
There are two major anti-ritalin camps to be aware of;

1. Parents against drugs in Children
2. Scientologists

In both cases, the objection isn't specifically against Ritalin, it's against almost every drug used with children. The suggestion being that dieting or meditation is a better option.

I know of some people who swear by dieting but I'm yet to see compelling evidence to support it. As far as meditation is concerned, I'm not going there... especially not with a 7 year old.

If you find an article in the paper or on the internet, or if you see a programme on TV that raises specific concerns about Ritalin, you should always check to see if one of these Anti-Ritalin groups are behind it. Otherwise, you may find yourself needlessly worrying about things.

Of course, when all is said and done... remember, it's your child and you have a responsibility for their wellbeing. If the medication affects them adversely or if they don't show immediate improvement (say within 2 weeks of use) then you should discontinue.

I'll do another post on Ritalin at a later date to cover things like the effects of coming off the drug, school holidays and weekends and the difference between morning and afternoon effects.

Tuesday, December 4, 2007

Life Repeats Itself

We are currently on holiday in a resort with a pool and we had an incident today which would have confounded me as a kid and still does from an adult point of view.

I'm not certain how much easier this situation might be for an NT but for an aspie, it was very challenging.

The Scenario
We bought my two children a swimming tyre each and they went down to the pool without their floaties. Fully reliant on the tyre for floatation should they drift into a deeper part of the pool.

My younger son (4) was ok but my older son (7) was hounded by two other kids for his tube. Their parents were nearby and watching but did nothing to stop the hounding.

Reluctant to berate someone elses child, I was unable to assist.

The Child's. Perspective
Watching the scenario play out, I was reminded of countless similar situations in my childhood. In my opinion, the other kids and their parents were at fault but the situation was unwinnable.

I'd either do one of two things;

1. Give the toy over.
I often simply gave the agressors what they wanted simply to avoid problems. They would take the item and not involve me in it's play. Not a good scenario. In some cases, I'd even get the toy back at the end of the day. Once, I took a brand new soccer ball to school and had to give it to "hasslers" just prior to my first class. I wasn't picked for teams at lunch time and didn't get my ball back until after school when it was well and truly dirtied and scuffed.

2. Fight
The second option is simply to argue and fight. Sometimes it becomes physical but most times you just lose "friends".

Neither option really works.

The Adult Perspective
In the pool toy case, the problem was with the adults too. I was surprised to find it just as insoluble.

I offered my son some advice, telling him that since it was his toy and it was the only thing keeping him afloat he didn't have to share. He told the kids that but still they came on.

I moved him away from the kids but they followed. I asked the kids to leave him alone but still they came on.

As the kids pushed my son closer and closer to a meltdown, I started calling to my NT wife. She spoke sternly to the kids and they listened for about 5 minutes but went back again.

She caught their eyes and made some threatening gestures (and shot an evil glance at them). That bought us another 5 minutes with one kid.

In the meantime, I got Kaelan (my son) who was getting into a heated arguement with the other kid, to start saying "talk to the hand" - an Americanism - surprisingly, it worked.

By "attacking" their kids, we finally galvanised their parents into action and they pulled their kids out of the pool.

I guess the point of this post is to say that social skills don't seem to improve, even on the adult side of the age barrier when the problem isn't the aspie but NTs.

Monday, December 3, 2007

Aspies and Perfection

Aspies are often their own worst enemies in the area of self worth. They often set themselves unattainable or inappropriate levels of perfection.

It is not uncommon for an aspie to consider a B- mark, or anything below it to be a failure. They will often berate themselves severely after such a "failure", usually calling themselves failures etc, and sometimes resorting to self-harm.

On the positive side, this means that aspies are very hard workers who strive not only to do impossible amouints of work but also to do it perfecly.

The downsides of employing an aspie are that;

Sometimes they introduce so many steps into a process (striving for perfection), that the process ends up being overly long and complicated.

They will work themselves into the ground. Personally, I tend to clock 9 to 10 hours per day and have tripped off overuse injuries on more than one occasion.

They find it impossibly hard to delegate work because although they generally don't apply the same perfectionist standards to others, they are still responsible for delegated work and often find themselves completely redoing the work during the checking phase.

They are hopeless on team assignments and group work and often find themselves doing the work of the whole team.